Mesenchymal chondrosarcoma (MC) is a rare tumour, with a predilection for the head and neck region. We describe a case of mesenchymal chondrosarcoma arising in the right maxilla extending to the basi-sphenoid. Its computed tomography (CT) and magnetic resonance imaging (MRI) and histopathological features and the management are presented. We also reviewed the literature of reported cases involving the maxilla.
Study design: Retrospective Cohort Study. Objective: Low back pain (LBP) and radiculopathy present a significant burden to patients and healthcare systems. Lumbar disc degeneration (LDD) is associated with LBP. While the prevalence of LDD in older, symptomatic, patients has been extensively documented there has been little describing the prevalence in younger patients. Methods: 1011 patients aged 20e30 years, who had undergone Magnetic Resonance Imaging (MRI), for investigation of LBP and or radiculopathy, over a 9-year period were identified. Those who had previous surgery, congenital deformities or unavailable imaging were excluded. A single surgeon evaluated the MRI images of 730 patients and classified each lumbar disc according to the Pfirrmann classification. 105 randomly selected patient's imaging was reviewed again by the primary reviewer and by a consultant musculoskeletal radiologist with the kappa coefficients for inter-rater and intra-rater agreement calculated. Results: Of the 730 patients, 428 (58.6%) had MRI evidence of LDD (Pfirrmann III, IV, V). 255 (59.6%) demonstrated single level pathology and 173 (41.4%) multilevel involvement. There was very high intra/ inter observer agreement with kappa coefficients for intra-observer agreement from 0.65 to 0.98 and inter-observer agreement from 0.51 to 0.88. Conclusions: This is the largest study to document the prevalence of LDD in a symptomatic young cohort. A large prospective study including non-symptomatic patients and information on associated factors would add further information. Given the considerably higher than anticipated prevalence identified in this study and the significant burden associated with LBP this study should encourage such further research.
Neurological complications resulting from single vertebral involvement have been described but the condition is usually asymptomatic (Dinneen & Buckley, 1987). The mechanisms for neurological involvement include compression of the spinal cord by bony expansion from the pagetic process, vertebral collapse with haemorrhage, or neoplastic degeneration (Resnick, 1988). Other non-compressive vascular causes have also been described (Herzberg & Bayliss, 1980; Douglas et al, 1981).
We describe a case of severe spinal cord compression secondary to Paget's disease, as a result of extradural pagetic ossification of the ligamentum flavum and epidural fat, with the actual bony spinal canal being of normal size.
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